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Nursing in the New Millennium

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Nursing in the New Millennium. Phyllis M. Connolly PhD, APRN, BC, CS. Nursing's responsibility is awesome in patient care and also in creating a new ... – PowerPoint PPT presentation

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Title: Nursing in the New Millennium


1
Nursing in the New Millennium
  • Phyllis M. Connolly PhD, APRN, BC, CS

2
Nursings responsibility is awesomein patient
care and also in creating a new society (Nyberg,
1998, p. 209)
3
3 Assumptions
  • Life at warp speed
  • New type of change, age of unreason
  • Constant change, permanent white water

4
Changing Work Environment
  • Technology
  • Demographics
  • Managed Care
  • Purchasers Influence
  • Health Insurance Industry
  • Changing Health Systems

5
Report Card Managed Care
  • Access
  • Quality/Appropriateness
  • Promotion/Prevention
  • Outcomes
  • General health improved
  • Quality of life improved
  • Treatment reduces psychological stress
  • More productive independent

6
ANA Initiatives Improve Quality of Health Care
  • 1994 Nursings Safety and Quality Inititive
  • 1996 Nursing-Sensitive Quality Indicators for
    Acute Care Settings
  • 1997 National Data Base of Nursing Indicators
    (NDQI)
  • CalNOC largest ongoing nursing quality
    measurement data set in nation

7
IOM (2001)Crossing The Quality Chasm Changes
Needed
  • Safe
  • Effective
  • Patient-centered
  • Timely
  • Efficient
  • equitable

8
IOM Rules for Redesign (2001)
  • Care is based on continuous healing relationships
  • Care is customized according to patient needs
    values
  • The patient is the source of control
  • Knowledge is shared information flows freely
  • Decision making is evidence-based

9
IOM (2003) Keeping Patients Safe Transforming
the Work Environment of Nurses
  • Address management practices
  • Workforce capability
  • Work Design
  • Organizational safety culture

10
Impact of Nursing Studies Patient Outcomes
  • Needleman et al.(2002) 1997 data
  • ? hrs care/day RNs medical pts.
  • ? LOS, rates of UTI, UGI bleeding, pneumonia,
    shock or cardiac arrest failure to rescue
  • ? hrs. care/day RNs surgical pts.
  • ? UTI, failure to rescue
  • Aiken et al.(2003)
  • 10 ? in proportion of BSN
  • ? 5 risk of patient death failure to rescue

11
Strategies Skills For Future
  • Ability to understand systems
  • Critical thinking, analysis and problem solving
  • Reframing
  • Personal growth mastery, ability to tolerate
    ambiguity take risks
  • Emotional intelligence self-restraint (impulse
    control) compassion

12
Strategies Skills For Future Cont.
  • can do spirit
  • Business leadership intelligence
  • Ability to manage change
  • Group management skills, negotiating conflict
    resolution
  • Stewardship
  • Collaborative leadership skills

13
AACN Role New Clinical Nurse Leader (Summary
draft 2003)
  • Clinician Leadership in care of sick across all
    environments
  • Outcomes manager
  • Client Advocate
  • Educator

14
AACN Clinical Nurse Leader Role Cont.
  • Information manager
  • Systems analyst/Risk Anticipator
  • Team Manager
  • Member of Profession

15
  • To be active participants in shaping the health
    care system, nurses must learn new skills
  • Alderman (2001, p. 50)
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